Musical Malfunction in the Operating Room

Good surgery has a certain flow to it. The setup of the room has its feng shui. All the necessary materials are already prepared. The anesthesia team has a smooth intubation. The surgical assistants and scrub techs anticipate the surgeon’s moves, handing off instruments and aiding visualization without so much as a word.

An elegant dance ensues, as a person who has agreed to be cut open on purpose, is dissected, repaired and sewn back together.

There is a groove coming from the speakers in the corner — just loud enough so everyone can hear, but never where people would need to raise their voices to communicate. Energetic and forward-moving. Never frantic. Accessible but interesting. U2, The Beatles, Ray Charles, Miles Davis, Paul Simon.

And then there’s last Thursday.

As a mid-level resident, I am slowly being entrusted to operate, albeit under massive amounts of supervision. I had read the textbook on the mandibular sagittal split osteotomies three times, and I walked through the dissection in my head in the shower on the day the knife would be in my hand.

At least on our service, it is important for the residents to know the music preferences and hardware of each attending surgeon. Thursday’s attending would come with his iPhone 4, and he would choose a Pandora station — often Wes Montgomery or some other 1960s West Coast Cool Jazz player.

Because we have yet to buy a new speaker set to fit everyone’s iPhone 5 (I’m an Android user myself), I was asked a few weeks ago to dig up my iPod and make a couple of mixes for the operating room.

The mixes I had made had gone over fairly well this month. Gipsy Kings, The Doors, Gotan Project, Radiohead, to name a few. When Pandora wasn’t giving us a satisfactory set of tunes on Thursday, someone asked the circulating nurse to switch over to my iPod.

Focused on my very first sagittal split, I only spent half a moment trying to tell her which playlist to select. I cringed a little after I realized that she had clicked on the “Play All Songs” button, but I figured people wouldn’t pay that much attention. Mind you, I have a lot of garbage on my iPod.

In a past life, I also played a fair amount of music, and it’s something in which I actually take a bit of pride. Unfortunately, the creative process isn’t always beautiful, and sometimes we record these things for our own self-improvement.

And then there’s the fact my name starts with an A.

One by one, poorly recorded demos of songs I had written or arranged over the past 15 years came up. In 2006, I had a crush on a girl who had placed me firmly in the friend box, and I had decided to write a 5-minute-long crooner about it — and record it twice with slightly different balances to decide which one made me feel the most depressed.

After nine shame-encrusted minutes, the circulating nurse actually got up just to switch the song, and exclaimed, after hitting the button, “Oh no! The next one is by him, too!”

The surgery stopped. “Akshay, who is this singing?” the attending asked.

“That would be … yours truly.”

Awkward silence.

“Can you please just click ‘Shuffle All Songs’?” I asked the circulator. I went back to my osteotomy and mandibular split.

“Anyone ever tell you that you kinda sound like Chet Baker?” the attending tried.

A few songs came and went without much incident, but it was only a matter of time before the circulator asked if someone’s cell phone had started playing a song, since she thought it sounded like there were two songs playing with discordant beats.

“No, that’s the Robert Glasper Experiment. It’s just one song,” I assured her.

“Oh, well it kinda sounds like there’s two different beats.”

“It’s Robert Glasper,” said the attending. “It’s art.”

Eventually, people stopped commenting on the music, but one terrible thing after another came up. Old hobo songs by Woody Guthrie, some 11-minute-long group improvisation from the mid-1970s, a random chase scene from the West Side Story soundtrack.

Eventually, the case ended, and the music was shut off. I returned to breathing. Future surgeons: Plan your music carefully — now, while you have time.

Akshay Govind is a third-year resident in the Department of Oral and Maxillofacial Surgery.

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